Samples are available with customer-supplied materials. After we receive the proper MSDS and Technical Data Sheets, we'll evaluate the information and get back to you about shipping the material to our facility. Sample requests are typically filled within five working days from receipt of materials.

The following request form must be filled out to obtain free samples. Or, if you'd like email us your request: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Contact Information Items marked with * are required. First Name * Last Name * Your Position * Company * Street * City * State * ====Please Select==== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware DistrictOfColumbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada NewHampshire NewJersey NewMexico NewYork NorthCarolina NorthDakota Ohio Oklahoma Oregon Pennsylvania RhodeIsland SouthCarolina SouthDakota Tennessee Texas Utah Vermont Virginia Washington WestVirginia Wisconsin Wyoming Zip * Country * Telephone * FAX * E-mail * Company Website Shipping Address (if different than above) Company Street City State ====Please Select==== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware DistrictOfColumbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada NewHampshire NewJersey NewMexico NewYork NorthCarolina NorthDakota Ohio Oklahoma Oregon Pennsylvania RhodeIsland SouthCarolina SouthDakota Tennessee Texas Utah Vermont Virginia Washington WestVirginia Wisconsin Wyoming Zip Country Telephone FAX Please identify the nature of your business and your specific interest What industry do you serve? What is the nature of your company\'s business? How many components do you want packaged? One Two Which company(s) will supply the chemical(s)? What are the names of the chemical(s)? How are you currently applying these materials? What style of APS package will be used for free sample? A-PAK Burst Seal A-PAK Divider Clip Bottle Cans Cartridge, caulking Cartridge, plain Dual Cartridge Jars Pre-Mixed & Frozen Cartridge Pre-Mixed & Frozen Syringe Semkit Package Single barrel syringe Tube, metal Tube, plastic Other If other... fill in here How did you hear about APS? Internet Directory Internet Search Engine Link from Other Website Trade Journal Word-of-mouth Other Please give us application details - How will chemicals be used? Type the characters you see in the picture below